A randomized controlled trial on the prevention of seroma after partial or total mastectomy and axillary lymph node dissection

Background: Wound seroma is one of the most frequent complications of mastectomy, but an effective strategy Tor its prevention has not yet been established. The purpose of this study was to determine the effectiveness of delayed shoulder exercise on the prevention of wound seroma after partial or total mastectomy with axillary dissection for the treatment of cancer. Methods: This study prospectively randomized two exercise schemes after mastectomy with axillary lymph node dissection. The immediate exercise group (n = 58) started shoulder exercise on the first postoperative day. In the delayed exercise group (n = 58) the movement of the upper limb was limited to usual daily activities during the first postoperative week. Results: Preoperative levels of shoulder function were regained within one month when shoulder exercise was delayed for one week after operation. Significant decrease of drainage volume and lower incidence of seroma formation were seen in the delayed exercise group. Conclusion: These observations suggest that seven days of unrestricted movement and avoiding active exercise of the shoulder joint, is the optimal routine reduce seroma formation after mastectomy.